OVARIAN DYSFUNCTION AND YOUNG WOMEN WITH ACUTE MYOCARDIAL ISCHEMIA Público
Engel Overcarsh, Patricia Mae (2013)
Abstract
OVARIAN DYSFUNCTION AND YOUNG
WOMEN WITH ACUTE MYOCARDIAL ISCHEMIA
By Patricia Engel Overcarsh
ABSTRACT
Background: The burden of cardiovascular disease is significant in women and men; however, the clinical presentation, risk factors, and outcomes vary. Whether the pathophysiology of ischemic heart disease has unique aspects in women and whether there are risk factors that are specific for women, such as reproductive factors, is unclear. The literature is conflicting on whether early natural menopause is associated with premature coronary heart disease in women. We hypothesize that young women who have suffered an acute myocardial infarction have more often undergone premature menopause than age-matched community-control women, and that early menopause correlates with depression.
Methods:This is a case control study comparing age and
type of menopause between women who have suffered an early acute
myocardial infarction (prior to the age of 60) and age and race
matched controls. Cases include 49 women hospitalized at an
Emory-affiliated hospital enrolled in the ongoing MI and Mental
Stress (MIMS) study. Community controls were drawn from the
Meta-Health study, which drew women from the Atlanta metropolitan
area. Controls were matched by age (+/- 3 years) and race in a 2:1
ratio of controls to cases.
Results:The case control study population was composed of a total 147 women (49 cases and 98 controls) with mean age being 50 years old and 67.4% blacks. Cases were more likely to be current smokers (58.3% vs. 17.4%), have a history of hypertension (71.4% vs. 35.7%), a history of diabetes (20.4% vs. 7.1%), and a history of dyslipidemia (73.5% vs. 36.7%). Cases also had a higher mean BDI score (13.1 vs. 9.2). While 62.5% of cases and only 51.6% of controls had reported having undergone menopause the difference between the two groups was not statistically significant (p= 0.212). Menopausal status was not significantly associated with early acute MI in bivariate analysis.
Conclusion: Neither menopausal status nor age underwent menopause were significantly associated with early acute MI in bivariate or multivariable models. However, we found that smoking, history of dyslipidemia, and history of hypertension were significant, independent risk factors associated with high risk for early acute MI.
Table of Contents
Introduction_________________________________________ 7
Methods___________________________________________ 12
Results____________________________________________ 16
Discussion_________________________________________ 19
Conclusions________________________________________ 21
References_________________________________________ 22
Tables____________________________________________ 25
Appendix A________________________________________ 33
Appendix B________________________________________ 34
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